Notes on the origin, nature, prevention, and treatment of Asiatic cholera / by John C. Peters.

  • Peters, John C. (John Charles), 1819-1893.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Notes on the origin, nature, prevention, and treatment of Asiatic cholera / by John C. Peters. Source: Wellcome Collection.

    109/256 (page 91)
    intestinal phenomena of cholera by assuming that the portal circulation is at first impeded by meeting the reflux current from the vena cava, and presently becomes reversed, so that the blood is forced back mto the mesenteric veins, till it distends their extreme ramifications upon the mucous membrane of the bowels, where its watery portions find a species of vent, just as dropsy takes place from obstruction in the heart, Hver, or kid- neys;^ from this surface the repellant force squeezes out the serous or watery portion of the blood, carrying with it the mu- cous epitheUum, thus constituting those serous or rice-water evacuations which are regarded as characteristic of cholera. These are declared not to be real secretions, but mechanical effu- sions or exudations, which are quite the reverse of vital actions. The kidneys also become mechanically congested, the return- ing current of blood from the kidneys is stopped, and a first effect of this is a cessation of the secretion of urine. The hepatic circulation is affected in like manner, thus suspending or impeding the secretion of bUe. Bell assumes that the so-caUed collapse of cholera is differ- ent from the coUapse of htemorrhage ; the first is active or dynamic, while the latter is passive or adynamic; the pulse in hasmorrhage becomes slower, softer, and feebler, till it ceases, but in cholera it is contracted, small, and wiry, as long as it can be felt. The heart in cholera is heard and felt to be struggling in an extraordinary state of excitement, and in the active endeavor to overcome spasmodic obstruction, it is found to be churning as if it would burst, causing a sound which it is difficult to describe, but which once heard can never be for- gotten. The first indication, according to this theory, is to bleed. When the sound and action of the heart convey the impres-